PTU - Polskie Towarzystwo Urologiczne
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Urodynamic study in BPH patients qualified for surgical treatment
Article published in Urologia Polska 2005/58/1.


Maciej Zbrzeźniak, Andrzej Borówka, Wojciech Husiatyński, Wojciech Pypno
Klinika Urologii Centrum Medycznego Kształcenia Podyplomowego w Warszawie
Kierownik kliniki: prof. dr hab. Andrzej Borówka


prostate, benign prostatic hyperplasia, urodynamic study, transurethral electroresection of the prostate


introduction and aim of the study
Benign prostatic hyperplasia (BPH) is the most common urinary disorder in elderly men. Surgical treatment results are dissatisfactory in spite of advances in surgical techniques. In such cases, the treatment outcome may be influenced by lower urinary tract disorders other than bladder outlet obstruction (BOO). We conducted a prospective trial using urodynamic study (UDS) to determine poor surgery outcome predictors.
material and methods
105 patients were qualified for surgery according to standard diagnostic procedures. All underwent UDS before and 6 months after surgical BPH treatment. The degree of BOO was determined on the basis of Abrams-Griffith's number (AGno) and bladder contractility based on Bladder Contractility Index (BCI). Surgical treatment efficacy was measured according to the recommendations of the 4th International Consultation on BPH.
Out of 90 analysed patients, UDS revealed lack of BOO (BOO [-] or BOO [+/-]) in 20 (24.7%) and detrusor hypocontractility (low BCI) in 30 cases (33.3%). Both conditions coexisted in 16 patients (17.8%). In patients with BOO [-] and low BCI, surgical treatment outcome was worse than in patient with BOO and normal BCI: 25% and 57% versus 94% and 90%. The differences reached statistical significance. When both conditions coexisted, the surgical outcome was satisfactory only in 11%.
UDS enabled the detection of lower urinary tract disorders, which negatively impacted surgical treatment outcome. In patients with BOO [-] and low BCI, dissatisfactory surgery outcome should be expected.


  1. Barry MJ, Boyle P, Foucroy J: Epidemiology and natural history of BPH. W: 3rd International Consultation on Benign Prostatic Hyperplasia pod red. Cocketta A. Scientific Communication Int 1996; 21-36.
  2. Berry SJ, Coffey DS, Walsch P: The development of human benign prostatic hyperplasia with age. J Urol 1984; 132; 474-479.
  3. Borówka A: Łagodny rozrost stercza. Farmacja Polska 1996; 52; 531-546.
  4. Bruskiewitz R, Christensen MM: Critical evaluation of transurethral resection and incision of the prostate. The Prostate 1990; Suppl 3; 37-38.
  5. Sonowalla FP, Pardanani SD: Transurethral incision versus transurethral re-section of the prostate. A subjective and objective analysis. Br J Urol 1992; 70; 174-177.
  6. Neal DE: Outcome of elective prostatectomy. Br J Urol 1989; 299; 762-767.
  7. Denis L, McConnel J, Yoshida O: The evaluation and treatment of lower uri-nary tract symptoms (LUTS) suggestive of benign prostatic obstruction. Consultation on BPH 1998; 669-684.
  8. Rollema HJ, Mastrigt RV: Improved indication and follow-up in transurethral resection of the prostate using the computer program CLIM: a prospective study. J Urol 1992; 148; 111.
  9. Clinical Research Criteria W: 4th international Consultation on Benign Prostatic Hyperplasia (BPH). Paris, 1997; 343-360.
  10. Robertson AS, Airey R, Griffits CJ, Sharples L, Neal DE: Detrusor contrac-tion strength in men undergoing prostatectomy. Neurourol Urodyn 1993; 12; 109-122.
  11. Jensen KME, Jorgensen JB, Mogensen P: Urodynamic in prostatism. II. Prog-nostic value of pressure/flow study combined with stop test. Scand J Urol Nephrol suppl 1988; 114; 72-77.
  12. Rollema HJ, van Mastrigt R: Improved indication and follow-up in transure-thral resection of the prostate using the computer program CLIM: A prospective study. J Urol 1992; 148; 111-116.
  13. McInerney PD, Robinson LQ, Weston PMT, Cox R, Stephenson TP: Assess-ment of the poorly contractile or acontractile bladder in the older male in the absence of neuropathy. Br J Urol 1990; 65; 161-163.
  14. Coolseat B, Blok C: Detrusor properties related to prostatism. Neurourol Urodyn 1986; 5; 435-447.
  15. Abrams P, Mattiasson A, Van Kerrebroeck P, Robertson G: Is nocturnal poly-uria a key factor in nocturia? Neurourol Urodyn 2004; 23; 466-467.
  16. Prajsner A, Tkocz M: Radykalność przezcewkowej elektroresekcji łagodnego rozrostu stercza na podstawie oceny wyników badania przepływowo-ciśnieniowego. Urol Pol 2001; 2; 48-52.


Maciej Zbrzeźniak
Klinika Urologii CMKP
01-416 Warszawa
ul. Czerniakowska 231
tel. (0...22) 629 34 07